The broad, long-term objective of the current research is to reduce alcohol use and related negative health, social, and legal consequences in a high-risk population of college students seeking health care at a university- based medical and mental health setting, through implementation and evaluation of effective, low-cost individual Screening and Brief Intervention (SBI) strategies. SBI strategies, particularly the Brief Alcohol Screening and Intervention for College Students (BASICS) model (Dimeff, Baer, Kivlahan, & Marlatt, 1999), have been supported by research to be an efficient and cost-effective means of reducing alcohol abuse (Baer, Kivlahan, Blume, McKnight, & Marlatt, 2001; Borsari & Carey, 2000; Larimer et al. 2001; Marlatt et al., 1998) and alcohol-related consequences (Baer et al., 2001; Marlatt et al., 1998) among college students. Further, we are beginning to better examine and understand the mechanisms that can result in behavior change using brief interventions (Carey, Carey, Maisto, and Henson, 2006; Carey, Henson, Carey, and Maisto, 2007). A significant limitation of the research on motivational-based SBI programs, including BASICS and other intervention formats, is that they have generally been conducted outside of naturalistic settings in which college students typically receive health-related services, such as campus-based health centers and counseling centers. Several studies have confirmed the effectiveness of SBI programs in both primary care settings (e.g., Fleming, Brown, & Brown, 2004; Reiff-Hekking, Ockene, Hurley, & Reed, 2005) and emergency rooms (e.g., Longabaugh et al., 2001; Monti et al., 1999), but this work has not exclusively sampled college students. The current research is designed to address these gaps in the literature by examining the efficacy and cost- effectiveness of the delivery of SBI in a variety of intervention formats in reducing alcohol use and related negative consequences in a target population of undergraduate and graduate students seeking services at university-based primary medical and mental health care settings. Specifically, the NIAAA Tier I Screening and Brief Intervention for College Students (BASICS) model (Dimeff at al., 1999), a commercially-available Web- based educational intervention for high-risk alcohol use (e-Chug), the administration of Web-delivered personalized drinking feedback (PDF)-only (Dimeff, et al., 1999), and an assessment-only (wait-list control condition), will be examined in regard to their short-term and longer-term efficacy. Second, the proposed research is designed to examine the role of mediators and moderators of intervention efficacy, both within and across treatment conditions. Third, this current research will examine patterns of and changes in participant academic performance and retention within the university environment during the course of this project. The specific aims of this research will be accomplished in the context of a longitudinal randomized trial study using a between-group design to assess the short-term and longer-term efficacy of BASICS, e-Chug, and personalized drinking feedback-only in reducing alcohol use and associated negative consequences. Specific emphasis will be placed on the evaluation of mediators and moderators on treatment efficacy, in an effort to better clarify the roles of these factors on short-term and long-term intervention outcomes. Additionally, the proposed project will evaluate patterns of and changes in participant academic performance and retention within the university environment across time for study participants. PUBLIC HEALTH RELEVANCE: The purpose of the current research study is to reduce alcohol use and related negative health, social, and legal consequences in a high-risk population of college students seeking health care at a university-based medical and mental health setting, through implementation and evaluation of effective, low-cost individual Screening and Brief Intervention (SBI) strategies. SBI strategies, particularly the Brief Alcohol Screening and Intervention for College Students (BASICS) model (Dimeff, Baer, Kivlahan, & Marlatt, 1999), have been supported by research to be an efficient and cost-effective means of reducing alcohol abuse (Baer, Kivlahan, Blume, McKnight, & Marlatt, 2001; Borsari & Carey, 2000; Larimer et al. 2001; Marlatt et al., 1998) and alcohol- related consequences (Baer et al., 2001; Marlatt et al., 1998) among college students. We will explore how these interventions work when delivered in different formats, such as face-to-face and via the Web.